Log In

Forgot Password?

OR

Not a member? Continue as a nonmember.

Become a Member

By becoming a member of the AAN, you can receive exclusive information to help you at every stage of your career. Benefits include:

Join Now See All Benefits

Loading... please wait

Abstract Details

Sex-specific lesion pattern of long-term functional outcome after stroke
Cerebrovascular Disease and Interventional Neurology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
13-004
Acute ischemic stroke (AIS) has a varying impact on men and women. For instance, women feature a higher AIS severity than men that cannot be fully explained by key clinical variables. Further, we observed distinct sex divergences in lesion topographies in a recent study of 555 AIS patients: when explaining AIS severity, women were characterized by more widespread lesion pattern. Only in women, AIS severity was particularly strongly affected by lesions in the left posterior circulation.

To determine sex-specific lesion pattern effects on long-term functional outcomes.

We relied on data of 822 AIS patients of the MRI-GENIE study (age:64.7(15.0), 39%female, 27%unfavorable outcome, mRS>2). AIS lesions were automatically segmented from DWI-images, spatially normalized and parcellated (atlas-defined 94 cortical, 15 subcortical regions, 20 white matter tracts). Subsequently, we employed data-driven matrix factorization to obtain ten quintessential lesion patterns. Unfavorable functional outcome was modeled via Bayesian hierarchical logistic regression, taking the ten sex-specific lesion patterns and the covariates age, age2, sex, hypertension, atrial fibrillation, diabetes, ischemic heart disease, prior stroke, smoking and total lesion volume as inputs.
We derived ten anatomically plausible lesion patterns that predominantly represented right- and left-hemispheric strokes with varying emphases on cortical-subcortical and anterior-medial-posterior regions. Three out of these ten patterns substantially contributed to the explanation of unfavorable outcome for both men and women (AUC=0.81). These lesion patterns primarily comprised bilateral subcortical grey matter regions and left-lateralized regions in proximity to the insula. Additionally, a lesion pattern of left posterior circulation brain regions had a substantially higher relevance in women compared to men.
We here present evidence that female-specific lesion pattern effects relating to left-hemispheric posterior circulation regions are not only implicated in the explanation of AIS severity, yet have a lasting effect and also impact long-term outcomes. Future work is needed to examine links to more granular behavior.
Authors/Disclosures
Anna Katharina Bonkhoff, MD (Mass General Brigham)
PRESENTER
Dr. Bonkhoff has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NeuroImage Clinical (Elsevier).
Martin Bretzner, MD (Mass General Brigham) Dr. Bretzner has nothing to disclose.
Sungmin Hong, PhD (MGH) Dr. Hong has nothing to disclose.
Markus D. Schirmer, PhD (Massachusetts General Hospital) Dr. Schirmer has nothing to disclose.
Christina Jern The institution of Christina Jern has received research support from Swedish Research Council. The institution of Christina Jern has received research support from Swedish Heart Lung Foundation.
Arne Lindgren Arne Lindgren has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Arne Lindgren has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS/Pfizer. Arne Lindgren has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novo Nordisk. Arne Lindgren has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pharma Industry. Arne Lindgren has received publishing royalties from a publication relating to health care. Arne Lindgren has received publishing royalties from a publication relating to health care.
Jane Maguire, PhD,RN (University of Technology Sydney) Prof. Maguire has nothing to disclose.
Danilo Bzdok No disclosure on file
Ona Wu, PhD (MGH Stroke Research Center) Dr. Wu has received stock or an ownership interest from Microsoft. Dr. Wu has received stock or an ownership interest from Disney. Dr. Wu has received stock or an ownership interest from Con Edison. Dr. Wu has received stock or an ownership interest from Cisco. The institution of Dr. Wu has received research support from NIH. The institution of Dr. Wu has received research support from AHA. The institution of Dr. Wu has received research support from Same You. The institution of Dr. Wu has received research support from Football Players Health Study. Dr. Wu has received intellectual property interests from a discovery or technology relating to health care. Dr. Wu has received intellectual property interests from a discovery or technology relating to health care. Dr. Wu has received intellectual property interests from a discovery or technology relating to health care. Dr. Wu has received personal compensation in the range of $500-$4,999 for serving as a grant reviewer with NIH.
Natalia S. Rost, MD, MPH, FAAN, FAHA (Massachusetts General Hospital) Dr. Rost has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for American Academy of Neurology. Dr. Rost has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke - AHA/ASA Journal. The institution of Dr. Rost has received research support from NIH. Dr. Rost has received publishing royalties from a publication relating to health care.